Forms

Insurance Forms

Please note that all information submitted is confidential and will not be shared with any third parties. You will be required to submit your email address and other contact information so that our Client Care representatives can contact you.

Property Insurance Forms

Fire Insurance Proposal Form
Property Fire/Loss Notice Form
Homeowners Insurance Renewal Form
Property Loss Claim Form

Motor Vehicle Insurance Forms

Motor Insurance Quotation Form
Motor Vehicle Accident Report Form
Third Party Insurance Loss Report Form
Motor Vehicle Windscreen Claim Form
Motor Renewal Declaration

Life Insurance Forms

Death Claim – Statement of Identity Form
Death Claim – Attending Physician’s Statement Form
Death Benefit – Claimant’s Statement Form
COVID-19 (Corona Virus) Exposure Questionnaire

Health Insurance Forms

Health Insurance Claim Form
ADmed Statement Attending Physician’s Statement Form
ADmed Claimant Statement Form

Group Insurance Forms

Employee Data Sheet
Application for Group Insurance
Enrollment Card
Adult Declaration of Health
Child Declaration of Health
Common Law Declaration

Client Complaint/ Enquiry Form

Compliance Forms

Politically Exposed Person Questionnaire
Foreign Account Tax Compliance Act (FATCA) Form

Direct Debit

Direct Debit Authorization Form

Request a Quote

Make a Payment

Roadside Assistance

ADmed Hotline

WhatsApp Us

Select a product and we’ll get you started

For more information, please contact our Client Care at 607-MARI (6274) or email cru@maritimefinancial.com

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